摘要
目的观察和比较持续静脉泵入吗啡与芬太尼透皮贴治疗顽固性癌痛的临床疗效和安全性。方法选择43例NRS≥7分的顽固性癌痛患者,将其随机分为吗啡组(持续静脉泵入吗啡)与芬太尼组(芬太尼透皮贴)。观察和比较两组患者的镇痛疗效、镇痛维持时间、爆发痛发作次数及不良反应发生情况。结果治疗后,吗啡组和芬太尼组的NRS评分分别为(1.9±0.8)分和(2.2±1.0)分,均较治疗前明显降低(P<0.05),但两组间的差异无统计学意义(P>0.05);吗啡组患者每天平均镇痛维持时间为(22.7±0.4)小时,爆发痛每天发作(1.0±0.3)次;芬太尼组每天平均镇痛维持时间为(20.1±1.2)小时,爆发痛每天发作(1.5±0.6)次,两组间的差异均无统计学意义(P>0.05)。两组患者的不良反应以头晕、便秘、恶心呕吐及排尿困难多见,经对症处理后均可耐受。结论持续静脉泵入吗啡及芬太尼透皮贴治疗顽固性癌痛均可明显缓解患者的疼痛症状,镇痛效果及安全性相当,建议长期住院的患者使用持续静脉泵入吗啡,而不需要长期住院的患者可尝试芬太尼透皮贴治疗。
Objective To observe and compare the curative effects and security of continuous intravenous Morphine Pump-ing and fentanyl transdermal patch for patients with intractable cancer pain. Methods Forty-three patients with intractable cancer pain （NRS≥7） were randomly assigned to morphine group （continuous intravenous Morphine Pumping） and fentanyl group （fenta-nyl transdermal patch group）. Analgesic efficacy, analgesic time, frequency of intense paroxysmal pain and adverse reactions were observed and compared between the two groups. Results After treatment, the NRS score of morphine group and fentanyl group was （1.9±0.8） and （2.2±1.0） respectively, both were significantly lower than before treatment （P0.05）. Patients in morphine group had daily average analgesia maintaining time for （22.7±0.4 ） hours, but （1.0±0.3） times of intense paroxysmal pain attack a day;patients in fentanyl group had daily average analgesia maintaining time for （20.1±1.2） hours, but （1.5±0.6） times of intense paroxysmal pain attack a day. There were no statis-tical differences between the two groups. The most common adverse reactions in the two groups were dizziness, constipation, nausea, vomiting and dysuresia, but all of them could be well tolerated after the symptomatic treatment. Conclusion Continuous intrave-nous Morphine Pumping and fentanyl transdermal patch both could obviously relieve the pain symptoms, and their analgesic effect and security had no differences. It is suggested that long-term hospitalization patients would better receive continuous intravenous pumping morphine, and non-long-term hospitalization patients may try fentanyl transdermal patch therapy.
出处
《肿瘤药学》
CAS
2014年第6期455-459,共5页
Anti-Tumor Pharmacy
关键词
持续静脉泵
吗啡
芬太尼透皮贴
顽固性癌痛
Continuous intravenous pumping Morphine Fentanyl transdermal patch Intractable cancer pain
